By Douglas Capraro
Unless you’ve been living under a rock for the past decade and a half, you’d know that the United States is facing one of its biggest drug epidemics ever. Opioid use, which not only includes the street drug heroin, but also licit prescription pain relievers such as oxycodone, hydrocodone, codeine, morphine, fentanyl and others, is on the rise.
Yet as policymakers continue to push for more effective methods of treatment for drug users, the number of deaths caused by drug overdoses show no signs of slowing down. Not only that, but statistics also show that between 40 and 60 percent of users who seek treatment relapse within the first year.
So what if there was a magic potion that would simply do away with the addictive aspects of opioids?
This may seem like wishful thinking, but scientists have already developed a vaccine that may help some people do just that. And while there is no “magic potion” capable of alleviating heroin addiction altogether, this vaccine can prove extremely useful in curbing drug users’ addiction to certain opioids as well as preventing the risk of fatal overdoses.
This new vaccine was developed by scientists from The Scripps Research Institute (TSRI) and targets an opioid called fentanyl. Fentanyl is a synthetic painkiller 50 to 500 times more potent than morphine. Drug dealers often cut heroin with Fentanyl, making it much more lethal for drug users. Variants of this drug have been sold under names such as “China white” and acetyl fentanyl and are responsible for an influx of drug related deaths in Rhode Island and Pennsylvania, two states that have been heavily effected by the recent drug epidemic.
What the vaccine does is mimic fentanyl’s core structure, which trains the immune system to produce antibodies that neutralize it. So far, this vaccine had been tested on mice and the results are extremely promising. Researchers found that their immune systems were neutralizing fentanyl months after their last injection. In addition, antibodies created by the vaccine protected against overdose by eliminating lethal levels of fentanyl while also creating an extremely high tolerance to the drug.
This is a major break through in the pharmacological treatment of addiction. And according to TSRI Research Associate Atsushi Kimishima, who is the co-first author of this new study alongside TSRI graduate student Paul Bremer, “To the best of our knowledge, our active vaccine is the first to ablate lethal doses of any drug of abuse.”
So if this vaccine is so miraculous, then why isn’t it already on the market? For one, the history of human drug vaccine testing is rocky at best.
According to Kim Janda, a chemist at the Scripps Research Institute and author of the fentanyl study, the idea for drug vaccines began as far back as the 1970s. Yet as drugs like methadone overshadowed drug vaccine research until the mid-1990s, recent studies have not been particularly successful.
In 2014, for instance, a cocaine vaccine study fell short of its intended goal. This is because researchers did not find the rate of abstinence to be much different between those who took the vaccine and those who had taken a placebo. In addition, an anti-smoking vaccine also turned out to be a disappointment.
Since the results of human drug vaccine testing has not been successful in the past, potential backers of this new drug vaccine are hesitant to throw their financial support behind yet another similar study. Another problem facing drug vaccine researchers though is the stigma of drug addiction.
Janda says that many companies and organizations who would be able to fund these kinds of expensive research studies do not wish to spend money on treating addiction as a neurological disorder. Instead, many of them still see addiction as a “moral failing.” According to Phil Skolnick, director of the Division of Pharmacotherapies and Medical Consequences of Drug Abuse at the National Institute on Drug Abuse (NIDA), “The problem is that pharma companies have not been terribly interested in addiction research.”
There’s also the issue of the vaccine’s effectiveness. Since this particular vaccine only targets fentanyl, drug users can relapse by taking a number of different kinds of opioids, such as morphine or painkillers. Janda also says that it is unlikely the vaccine would work for 100 percent of the people taking it. Booster shots would be needed over the course of several months, and some patients may not be able to take every one, especially considering the cost of the vaccine.
However, as Skolnick puts it, “There’s no magic bullet for addiction.” There are many factors that contribute to addiction and any solution to the problem would require several different measures. A vaccine for opioids though is definitely a step in the right direction, especially if it helps reduce the number of fatal overdoses and the amount of people who relapse. Right now, TSRI are raising funds to begin testing the vaccine in non-human primates through a collaboration with Virginia Commonwealth University. If everything goes smoothly, we may gain a creative new tool to help fight addiction in the not-too-distant future.